The Berwick report on patient safety – is there a place for telemonitoring? (UK)

Reading and listening to the debates in recent days about whether the excellent Berwick report should have mandated staffing ratios, instead of leaving such guidance, as his report does, to NICE, I wondered to what extent technology had been considered to have an important role in improving patient safety.

The best example I can think of why this can be important, from my Newham days, was people prone to night-time fits that used to require dedicated human monitoring throughout the night.  By installing appropriate telecare we were able both to improve patient outcomes by enabling people to sleep on their own without outside disturbance at the same time as reducing significantly the cost of night-time care: a case where technology simultaneously enabled an improved level of care and a reduced staffing level.

It was therefore reassuring to find on Page 22 under the heading “A note on staffing ratios”:

“Our primary recommendation on staffing patterns is that NICE undertake as soon as possible to develop and promulgate guidance based on science and data. Such guidance, we assume, would include methods by which organisations should monitor the status of patient acuity and staff workload in real time, and make adjustments accordingly to protect patients and staff against the dangers of inadequate staffing. We also assume, and hope, that innovations will develop and continue in technologies, job designs, and skill mix that will and should change ideal staffing ratios, so that this role for NICE ought to be ongoing.”

I’d hasten to add that I am not advocating general use of telemonitoring in response to the report – merely to point out that there are some specific occasions where technology can help, and those are increasing as new technologies, possibly such as smart floors, are developed.

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